Bloating is one of the most common symptoms associated with menopause. Why is that, and what can we do about it?

Bloating is a common and widespread issue for women. It's a symptom that can be caused by various factors, including diet, lifestyle, and underlying medical conditions. Women are more susceptible to bloating because of gynaecological conditions and hormonal fluctuations during the menstrual cycle. Bloating can also be a normal part of the digestive process, in reaction to the food we eat; and many people experience it from time to time. However, chronic or severe bloating that interferes with daily life may require medical evaluation. 

“During perimenopause and menopause our gut microbiome is disrupted, which can lead to an overgrowth of less beneficial bacteria. Bloating can be a physical symptom of this dysbiosis. Oestrogen and progesterone are involved in fluid balance in the body, and when these hormones are declining and fluctuating this can cause bloating and fluid retention.”

Low oestrogen levels can also be associated with bloating in some women. While it may seem contradictory to the notion that high oestrogen levels can cause bloating, low oestrogen levels can lead to changes in the body that result in abdominal discomfort and bloating. 

Here's how low oestrogen can contribute to bloating:

• Slower Digestive Transit: Oestrogen plays a role in regulating the speed of the digestive transit, which affects how quickly food moves through the digestive system. When oestrogen levels drop, as seen in menopause or during the menstrual cycle, it can lead to slower digestion. Sluggish digestion can cause food to linger in the intestines longer, leading to gas production and bloating.
• Altered Gut Microbiota: Oestrogen has been found to influence the composition of gut bacteria. Low oestrogen levels can disrupt the balance of gut microbiota, potentially leading to digestive issues and bloating.
• Constipation: Low oestrogen levels can contribute to constipation, which can lead to abdominal discomfort and bloating as stools accumulate in the colon.
• Hormonal Changes: During the perimenopausal and menopausal stages, when oestrogen levels decline significantly, some women may experience bloating and changes in their body shape, including increased fat storage in the abdominal area.
• Gastrointestinal Motility: Oestrogen can influence the motility of the gastrointestinal tract. Low oestrogen levels may slow down the contractions of the intestines, which can affect the movement of food and gas.

It is important to note that bloating is not only related to hormones but can also be caused by many other issues, outlined below.

Some common causes of bloating in women include:

1. Gas and Digestive Issues

• Overeating: consuming large meals or eating too quickly can lead to bloating.
• Gas production: certain foods (like beans, broccoli, cabbage, fermented foods and carbonated beverages) can produce excess gas in the digestive system.
• Irritable Bowel Syndrome (IBS): a common digestive disorder that can cause bloating, cramping, and changes in bowel habits.
• Food intolerances: lactose intolerance, gluten sensitivity, and other food intolerances can lead to bloating when the trigger foods are consumed.
• Constipation: when stools build up in the colon, this can cause abdominal discomfort and bloating.

2. Menstrual Cycle

• Many women experience bloating and water retention as part of their menstrual cycle, typically during the premenstrual and menstrual phases.

3. Hormonal Changes

• Hormonal fluctuations during pregnancy, perimenopause, or menopause can lead to changes in the abdominal area and cause bloating.

4. Gynaecological Conditions

• Conditions such as ovarian cysts, uterine fibroids, or endometriosis can cause abdominal bloating and discomfort.

5. Fluid Retention

• Conditions like premenstrual syndrome (PMS), kidney problems, or heart conditions can lead to fluid retention and bloating.

6. Inflammatory Bowel Disease (IBD)

• Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation and bloating in the digestive tract.

7. Gastrointestinal Infections

• Bacterial or viral infections, such as gastroenteritis, can lead to acute bloating and digestive discomfort.

8. Stress and Anxiety

• Stress and anxiety can affect the digestive system, leading to bloating and other gastrointestinal symptoms.

9. Medications

• Some medications, like certain birth control pills or pain relievers, can cause bloating as a side effect.

10. Ovarian Cancer (rare)

• In some cases, persistent bloating can be a symptom of ovarian cancer, though this is less common.

If you are experiencing chronic or severe bloating – especially if it's accompanied by other concerning symptoms like unexplained weight loss, blood in the stool, or persistent pain – it is important to consult a doctor for a proper evaluation and diagnosis. They can help determine the specific cause of your bloating and recommend appropriate treatment or management strategies.

As a nutritional therapist in clinical practice, it is very common for women to report occasional or severe bloating; and in my experience, the right diet, lifestyle changes and balancing your hormones can make a huge impact. A one-to-one consultation with a nutritional therapist will give you a personalised plan and may include functional testing (a microbiome stool test or gut barrier panel) that will help you understand what is happening in your body and how best to manage it.

One of the bacteria strains that we have included in The Better Gut Biotic supplement is Lactobacillus Rhamnosus, which has been shown in clinical studies to improve bloating. Additionally, Lactobacillus Rhamnosus supports vaginal health, immunity, stress, anxiety and inflammation.